Adult ADHD in California.

This guide covers what a real adult-ADHD evaluation looks like, when telehealth fits well, when in-person care is the right path, and how to think about insurance and superbills as a California resident. The framing is practical, not clinical: it does not replace a conversation with a doctor, and it is not medical advice.

It is written from how NorCal ADHD actually runs care. Where there are clinical questions that depend on the individual, the guide says so.

The first appointment at NorCal ADHD is booked as a 90-minute slot on a secure call with Dr. D. Some visits finish closer to 30 minutes; some take most of the window. The goal is to understand your situation: how attention, energy, and follow-through show up at work, in relationships, in routines, in sleep, in the parts of your life that matter to you. A good evaluation pays attention to what is actually happening, not just to whether a checklist of symptoms is checked.

Dr. D will ask about history, current life, prior treatment if any, family context, sleep, substances, and other care you may already have in place. Adult ADHD often co-exists with anxiety, mood, sleep disruption, or other conditions; an honest evaluation names that complexity rather than collapsing it into a single label.

Adult ADHD care is mostly conversation and follow-up. After the first evaluation, ongoing care is built around messaging, scheduled calls, and the operational work of keeping treatment running (pharmacy, authorizations, scheduling). All of that fits telehealth well. NorCal ADHD uses Spruce for secure messaging and short, scheduled calls.

Telehealth also fits the actual lives of California adults: long commutes, hybrid work, parenting schedules, and the simple fact that a 30-minute appointment in a clinic across the Bay is a half-day off the calendar.

Some situations call for in-person evaluation or care that NorCal ADHD does not provide. Active substance dependence, conditions like bipolar disorder or psychosis, complex medication needs beyond first-in-class adult ADHD treatment, or severe co-occurring eating disorders are examples where a different setting is more appropriate. Dr. D will say so directly when that is the case.

NorCal ADHD is not an emergency service. If you are in crisis, call 911 or seek emergency care.

NorCal ADHD is an out-of-network private practice. Patients pay the practice directly. We do not bill insurance. We provide superbills (itemized statements) that you can submit to your insurance plan for possible out-of-network reimbursement. Reimbursement depends entirely on your specific plan, and we cannot guarantee it.

This is a deliberate choice. Direct insurance payment comes with rules that often work against the kind of careful, slow, one-doctor-one-team care NorCal ADHD provides. Private-pay gives the practice and the patient room to focus on what is clinically right, not what is reimbursable.

Insurance is still required as a NorCal ADHD patient. ADHD care can involve labs, primary care coordination, pharmacy requirements, medication authorizations, and other care needs that live outside NorCal ADHD. Insurance keeps that broader care available when needed.

Adult ADHD medications often involve controlled-substance rules, monthly refill limits, pharmacy stock that varies by location and week, brand-versus-generic decisions, and insurance prior-authorization requests. California has specific rules on top of federal ones. Pharmacies have their own constraints around what they will fill and when.

Most adult ADHD care leaves the pharmacy work to the patient. That fails the patients who most need ADHD care to begin with. NorCal ADHD treats pharmacy work as part of care: stock checks, substitution options, prior authorizations moved quickly, dose or formulation options when appropriate, and old-school doctor-pharmacist relationships when calling matters.